Tips for Parents to Manage Stress When Their Baby is in the Neonatal ICU

Ten to fifteen percent of newborn babies born in the U.S. need some care in a hospital neonatal intensive care unit (neonatal ICU). The most common reason babies need to be in a neonatal ICU is for premature birth.

Some common conditions for premature babies or preemies include respiratory conditions due to immature lungs, jaundice, heart problems, difficulty feeding, or low blood cell count. And this often means they need special care before they’re ready to come home from the hospital.

Having a preemie can be very stressful for parents. The birth may not have gone as expected. They are worried about their baby’s health. They may not be able to hold their baby as much as they’d like since they may be in an incubator and hooked up to tubes to monitor their heart rate or breathing or to receive oxygen, medication or nourishment – just to keep them alive.

In addition to highly trained doctors and nurses that help care for babies in the neonatal ICU, there are also hospital social workers who help parents with all the psychological and social aspects.

How hospital-based social workers help patients
Hospital-based social workers look at the social determinants of health of a patient, such as access to food, shelter, being able to pay bills, insurance situation, medications, long term health needs, crisis situations, etc.

They make referrals to community resources that help with those needs as well as referrals to medical specialists or behavioral health providers. They help patients transition to the next level of care, whether the patient is going to rehabilitation therapy or going home.

“As social workers we act as a liaison between patients and providers. We help decipher medical speak for patients and help people understand what a diagnosis means for families. We remind providers what things feel like for patients and families,” said Allyson Howell, a licensed clinical social worker at Intermountain Medical Center.

“For parents with a baby in the neonatal ICU, we’re really trying to address the needs of both the patient and the parents. No one wants to or plans to have a baby in the neonatal ICU. It’s kind of a traumatic, crisis situation for anyone,” said Howell.

Parents have many stresses when their baby is in the neonatal ICU
Howell sees the different things that make having a baby in the neonatal ICU stressful. First of all, the mom is still recovering from childbirth. And then parents may be traveling back and forth daily to be with their baby in the hospital. The baby may have special feeding needs. If the baby is unable to breastfeed, the mom may need to pump breastmilk. Depending on the level of ICU care needed, the parents may be far from home.

“Any time a mom is separated from her newborn it’s difficult. Their needs run together. And parents feel torn between different loyalties, especially if they have older children at home,” added Howell.

Mom or Dad may be taking time off from work or need to get back to work. The regular routine of life is disrupted and not everyone is all together at home as planned.

“We empower patients to do things for themselves. We talk them through things and help them think through the logistics of what they need to do next. We provide encouragement and help build their confidence,” said Howell.

When parents go home, they may need special equipment to help their baby such as bilirubin lights for jaundice or feeding tubes to help until the baby is more mature and can feed normally.

“I think part of our role for babies born very early, is we understand the long-term outlook for parents and that having a premature baby or baby with special needs is a marathon, and not a sprint. Their lives may still be on hold some months down the road,” said Howell.

Self-care tips to help new parents manage stress
Howell teaches parents eight ways to make sure they’re taking care of themselves for the long haul, by reminding them to take care of their own basic needs with an acronym called SUNSHINE.

“Dads need self-care too. They’re easy to overlook. Mom had the baby, the baby is in the neonatal ICU, and often Dad feels helpless. Often Dads think they’re fine, but this is hard for them too,” said Howell.

SUNSHINE

• Sleep: Aim for a 4-6 hour stretch of sleep at least three nights per week. Consider having a family member or friend give the first feeding of the night.
• Understanding: Counseling with a trained maternal mental health professional can prevent and treat depression and anxiety. Talk to an OB provider about concerns and for a referral.
• Nutrition: Continue taking prenatal vitamins. Avoid caffeine and sweets when possible, and include lean protein and unsaturated fats in snacks and meals.
• Support: Share feelings with a trusted friend or family member, or find a support group. Ask for help with baby care.
• Hydration & Humor: Drink two large pitchers of water daily. Dehydration can lead to fuzzy thinking. Make time for silliness and joy each day. If laughter seems impossible, it’s time to seek support.
• Information: Read about emotional wellness at www.postpartum.net. Track emotional health by taking the Edinburgh Postnatal Depression Scale assessment each month for a year. Contact a provider if score is 10 or higher, or if having thoughts of self-harm.
• Nurture: Schedule time weekly basis for doing things outside of motherhood. Make time for nature, scripture, art, prayer, music, meditation, creative hobbies, dates with friends or partner.
• Exercise: Walking 10-20 minutes per day can help body, mind, and spirit. Yoga and stretching can also be helpful. Go slowly at first

How family and friends can support parents at this difficult time
Accept offers of help or ask for help from family or friends to take care of basic needs like laundry, meals, housework, childcare of older kids. Ask them to bring healthy snacks.

“Let people know you may still need support after baby comes home. That may be when the full effects of stress or behavioral health concerns take effect. It helps if parents lower their expectations and focus on the most important things,” said Howell.

For more information
Intermountain has a free behavioral health resource for everyone, call the Intermountain Behavioral Health Navigation Line at 833.442.2211. It’s free and can be reached seven days a week from 7 am to 7 pm. It connects callers with a trained care coordinator who can provide appropriate self-care tools, peer support, treatment options, crisis resources, and more. The line can also connect people to a behavioral health provider for consistent care. There are behavioral health telehealth options which can be done from the hospital bedside or at home.

There is also a list of qualified behavioral health providers in Utah at www.helpmegrowutah.org or call 211 or access the Utah Maternal Mental Health Referral Network at www.maternalmentalhealth.utah.gov.

About Intermountain Healthcare

Based in Utah with locations in seven states and additional operations across the western U.S., Intermountain Healthcare is a nonprofit system of 33 hospitals, 385 clinics, medical groups with some 3,800 employed physicians and advanced practice providers, a health plans division with more than one million members called SelectHealth, and other health services. Helping people live the healthiest lives possible, Intermountain is committed to improving community health and is widely recognized as a leader in transforming healthcare by using evidence-based best practices to consistently deliver high-quality outcomes at sustainable costs. For more information, see Intermountain Healthcare.